37000 Feet | Browse and search NASA's Aviation Safety Reporting System |
|
Attributes | |
ACN | 345163 |
Time | |
Date | 199608 |
Day | Sat |
Local Time Of Day | 0001 To 0600 |
Place | |
Locale Reference | airport : yqx |
State Reference | NF |
Altitude | msl bound lower : 496 msl bound upper : 10000 |
Environment | |
Flight Conditions | IMC |
Light | Night |
Aircraft 1 | |
Controlling Facilities | tracon : yqx tower : yqx tower : crq |
Operator | common carrier : air carrier |
Make Model Name | L-1011 Tri-Star All Series |
Operating Under FAR Part | Part 121 |
Navigation In Use | Other |
Flight Phase | descent : approach descent other landing : go around |
Flight Plan | IFR |
Person 1 | |
Affiliation | company : air carrier |
Function | flight crew : first officer |
Qualification | pilot : atp |
Experience | flight time last 90 days : 200 flight time total : 4100 flight time type : 800 |
ASRS Report | 345163 |
Person 2 | |
Affiliation | company : air carrier |
Function | flight crew : captain oversight : pic |
Qualification | pilot : atp |
Events | |
Anomaly | non adherence : published procedure other anomaly other |
Independent Detector | other controllera other flight crewa |
Resolutory Action | controller : issued new clearance other other |
Consequence | Other |
Supplementary | |
Primary Problem | Flight Crew Human Performance |
Air Traffic Incident | Pilot Deviation |
Narrative:
Event occurred at conclusion of a scheduled day beginning with an XA00L/XE30Z showtime. Crew flew a 4:42 leg from gander, newfoundland, to mco, cleared customs, etc, then flew a 4:26 leg returning to cyqx. This flying day followed a 12 hour layover proceeded by a 1:25 ferry from miami to orlando, and a 4:18 orlando to gander. Odd hours/circadian impacts on crew performance. Gander ATIS reported ceiling 300 ft winds 280 degrees/7 KTS. ILS runway 31 or ILS runway 4 available. Crew began letdown from FL370 late (97 DME, normally 115-120) and captain extended full speed brakes with 320 KIAS passing 18000 ft. Captain had appeared fatigued, but was revived and alert for letdown, as this copilot expected. Crew initially proceeded direct to gander VOR, approach turned us 15 degrees right for vector to intercept ILS runway 4, captain's runway selection. Passing 30 DME we were descending through 15000 ft at 310 KIAS and the L-1011 does not both go down and slow down, it only does one of those at a time even with brakes out. Copilot anticipated need for room and asked gander approach how far on ILS final our vector would take us. Gander responded '9 mi.' I mentioned to captain, 'is this going to work?' he said 'we'll make it, gear down.' we intercepted final, overshot by a huge margin with a 90 degree intercept, at 9 DME, 7000 ft, gear down, flaps at 4 degrees and speed brakes partially extended. Using 45 degree turn back, recrossed localizer and continued s-turns, slowing by breaking descent rate and extending flaps. At 4 DME, passing 2400 ft MSL/radar altimeter alive, GS? And s-turning for the localizer. Somewhere, tower inquired our status -- 'continuing, wind check, please.' copilot caught field at 1:30 relative, 900 ft AGL at 1 mi -- 'can't make it' at same moment tower instructed 'execute missed approach.' the captain called 'missed approach,' and added power and leveling. He then called 'gear up, flaps 10 degrees.' copilot responded, 'only 1.4 EPR, airspeed 142 KTS, flaps to 22 degrees.' captain then added tower per our takeoff and landing data card to 1.532 (I think), bugs set for go around, and increased airspeed as well as climb rate, copilot called 'flaps to 10 degrees.' we then switched to approach frequency and in view of ragged bottoms of the cloud deck, elected to complete localizer backcourse runway 22 approach, normal conditions ensued. This excessively nonstandard approach could have been avoided in several ways: 1) let down in holding, 2) vector to 25 or 20 mi final. This is the third time I have arrived on a high speed, 90 degree intercept to final at gander and failed to stabilize the approach for landing. Each occurrence was in darkness, IMC! Crew, and gander approach, share responsibility for the manner in which approach was commenced. The captain, a check airman with yrs of USAF C141, and part 121 major airline experience, elected to 'john wayne it' in actual IMC. Copilot brought up consideration for options but should have been more assertive. Flight engineer never said anything other than checklist responses.
Original NASA ASRS Text
Title: A SUPPLEMENTAL ACR L1011 FLC DSNDS LATE AND THEN IS TOO HIGH TO MAKE A SAFE, STABILIZED APCH, BUT ATTEMPTS THE APCH ANYWAY AND DOES NOT GAR UNTIL ORDERED TO DO SO BY THE TWR CTLR. THE MISSED APCH WAS NOT WELL DONE EITHER.
Narrative: EVENT OCCURRED AT CONCLUSION OF A SCHEDULED DAY BEGINNING WITH AN XA00L/XE30Z SHOWTIME. CREW FLEW A 4:42 LEG FROM GANDER, NEWFOUNDLAND, TO MCO, CLRED CUSTOMS, ETC, THEN FLEW A 4:26 LEG RETURNING TO CYQX. THIS FLYING DAY FOLLOWED A 12 HR LAYOVER PROCEEDED BY A 1:25 FERRY FROM MIAMI TO ORLANDO, AND A 4:18 ORLANDO TO GANDER. ODD HRS/CIRCADIAN IMPACTS ON CREW PERFORMANCE. GANDER ATIS RPTED CEILING 300 FT WINDS 280 DEGS/7 KTS. ILS RWY 31 OR ILS RWY 4 AVAILABLE. CREW BEGAN LETDOWN FROM FL370 LATE (97 DME, NORMALLY 115-120) AND CAPT EXTENDED FULL SPD BRAKES WITH 320 KIAS PASSING 18000 FT. CAPT HAD APPEARED FATIGUED, BUT WAS REVIVED AND ALERT FOR LETDOWN, AS THIS COPLT EXPECTED. CREW INITIALLY PROCEEDED DIRECT TO GANDER VOR, APCH TURNED US 15 DEGS R FOR VECTOR TO INTERCEPT ILS RWY 4, CAPT'S RWY SELECTION. PASSING 30 DME WE WERE DSNDING THROUGH 15000 FT AT 310 KIAS AND THE L-1011 DOES NOT BOTH GO DOWN AND SLOW DOWN, IT ONLY DOES ONE OF THOSE AT A TIME EVEN WITH BRAKES OUT. COPLT ANTICIPATED NEED FOR ROOM AND ASKED GANDER APCH HOW FAR ON ILS FINAL OUR VECTOR WOULD TAKE US. GANDER RESPONDED '9 MI.' I MENTIONED TO CAPT, 'IS THIS GOING TO WORK?' HE SAID 'WE'LL MAKE IT, GEAR DOWN.' WE INTERCEPTED FINAL, OVERSHOT BY A HUGE MARGIN WITH A 90 DEG INTERCEPT, AT 9 DME, 7000 FT, GEAR DOWN, FLAPS AT 4 DEGS AND SPD BRAKES PARTIALLY EXTENDED. USING 45 DEG TURN BACK, RECROSSED LOC AND CONTINUED S-TURNS, SLOWING BY BREAKING DSCNT RATE AND EXTENDING FLAPS. AT 4 DME, PASSING 2400 FT MSL/RADAR ALTIMETER ALIVE, GS? AND S-TURNING FOR THE LOC. SOMEWHERE, TWR INQUIRED OUR STATUS -- 'CONTINUING, WIND CHK, PLEASE.' COPLT CAUGHT FIELD AT 1:30 RELATIVE, 900 FT AGL AT 1 MI -- 'CAN'T MAKE IT' AT SAME MOMENT TWR INSTRUCTED 'EXECUTE MISSED APCH.' THE CAPT CALLED 'MISSED APCH,' AND ADDED PWR AND LEVELING. HE THEN CALLED 'GEAR UP, FLAPS 10 DEGS.' COPLT RESPONDED, 'ONLY 1.4 EPR, AIRSPD 142 KTS, FLAPS TO 22 DEGS.' CAPT THEN ADDED TWR PER OUR TKOF AND LNDG DATA CARD TO 1.532 (I THINK), BUGS SET FOR GAR, AND INCREASED AIRSPD AS WELL AS CLB RATE, COPLT CALLED 'FLAPS TO 10 DEGS.' WE THEN SWITCHED TO APCH FREQ AND IN VIEW OF RAGGED BOTTOMS OF THE CLOUD DECK, ELECTED TO COMPLETE LOC BACKCOURSE RWY 22 APCH, NORMAL CONDITIONS ENSUED. THIS EXCESSIVELY NONSTANDARD APCH COULD HAVE BEEN AVOIDED IN SEVERAL WAYS: 1) LET DOWN IN HOLDING, 2) VECTOR TO 25 OR 20 MI FINAL. THIS IS THE THIRD TIME I HAVE ARRIVED ON A HIGH SPD, 90 DEG INTERCEPT TO FINAL AT GANDER AND FAILED TO STABILIZE THE APCH FOR LNDG. EACH OCCURRENCE WAS IN DARKNESS, IMC! CREW, AND GANDER APCH, SHARE RESPONSIBILITY FOR THE MANNER IN WHICH APCH WAS COMMENCED. THE CAPT, A CHK AIRMAN WITH YRS OF USAF C141, AND PART 121 MAJOR AIRLINE EXPERIENCE, ELECTED TO 'JOHN WAYNE IT' IN ACTUAL IMC. COPLT BROUGHT UP CONSIDERATION FOR OPTIONS BUT SHOULD HAVE BEEN MORE ASSERTIVE. FE NEVER SAID ANYTHING OTHER THAN CHKLIST RESPONSES.
Data retrieved from NASA's ASRS site as of July 2007 and automatically converted to unabbreviated mixed upper/lowercase text. This report is for informational purposes with no guarantee of accuracy. See NASA's ASRS site for official report.